Middle colic nodes

At a glance

English

Middle colic nodes

Latin (TA2)

Nodi colici medii

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the middle colic nodes

The middle colic nodes are part of the superior mesenteric group. They follow the middle colic artery, which leaves the superior mesenteric artery just below the neck of the pancreas and runs forward into the transverse mesocolon, where it splits into right and left branches for the transverse colon.

Lying within the transverse mesocolon, the nodes hang in the fold of peritoneum that suspends the transverse colon from the front of the pancreas. They sit between the stomach above and the coils of small intestine below, and they lie in line between the paracolic nodes on the bowel wall and the main superior mesenteric nodes at the root of the artery.

Their lymph comes from the paracolic nodes of the transverse colon, mainly its right two-thirds, though the boundary with the left colic territory varies. From them lymph runs back along the artery to the superior mesenteric nodes at its origin, then into the pre-aortic group and the intestinal trunk.

Cancers of the transverse colon spread first to the paracolic nodes and then to this group. A transverse colectomy or extended right hemicolectomy therefore divides the middle colic artery near its origin, so that the nodes along it come away with the bowel. Tumours of the stomach or pancreas that invade the mesocolon can also reach them, so the group is checked at operations for those cancers as well.

Course and drainage

Begins at

Efferent vessels of the paracolic nodes of the transverse colon, mainly its right two-thirds.

Drains into

Efferent vessels pass to the superior mesenteric nodes at the origin of the artery, then to the pre-aortic nodes and the intestinal trunk.

Drains

Drain the transverse colon. They are the second station for transverse colon cancer, so surgery removes them with the artery and the mesocolon, and their involvement guides staging.